Chlamydial and ureaplasmal infections in patients with nonbacterial chronic prostatitis

Abstract

Our study was designed to establish the necessity of routine evaluation of patients with inflammatory (IIIA) and noninflammatory (IIIB) types of nonbacterial prostatitis (NBP) for chlamydial and ureaplasmal infections. From 1999 to 2001, 165 patients with a mean age of 35 years (range 20-54 years) were evaluated for the syndrome of chronic prostatitis. The evaluation included scoring with Prostate Symptom Score Index (PSSI) and NIH Chronic Prostatitis Symptom Index (CPSI), Meares-Stamey test and culturing of post-massage urine portion (fourth glass). In all cases, polymerase chain reaction (PCR)-testing of the semen was performed to establish the persistence of Chlamydia trachomatis (ChT) and Ureaplasma urealyticum (UU). Based on laboratory findings (four glass test and post-massage urine culture), in 69 (42%) of 165 cases, NBP was diagnosed, which includes 30 patients with type IIIA and 39 with type IIIB of NBP. According to semen PCR tests, in 11 (36.6%) of 30 cases with IIIA type of NBP, chlamydial (six cases), ureaplasmal (four cases) and a mixture of both (one case) infections were described. Among 39 patients with IIIB type of NBP test was positive in 14 cases (36%), where UU was presented in eight and ChT in six cases. In patients with previously diagnosed inflammatory as also noninflammatory NBP, according to four glass test, chlamydial and/or ureaplasmal infections can be presented. Although their role in pathogenesis of prostatitis remains speculative, however, testing for infections is highly recommended.

Experimental rodent models of prostatitis: limitations and potential

“…Although it was not clear whether the dorso-lateral prostate was involved or not this model demonstrated two distinct histological phases of bacterial inflammation in the ventral prostate. 73 During the initial acute infection stage (days [1][2][3][4][5][6][7][8][9][10][11][12][13][14] an acute response to the bacterial challenge with florid infiltration of polymorphonuclear cells into bacteria-containing spaces was observed. 74 As the infections became chronic, heavy lymphocyte infiltration and fibrous tissue proliferation completely engulfed the ventral prostatic lobe.…”

“…10,12,13 The remaining 60-95% cases of clinical prostatitis (categories IIIA and IIIB) may involve (i) hormonal imbalance; 14,15 (ii) neurological dysfunction; 16,17 (iii) a-adrenergic system abnormalities; [18][19][20] (iv) urinary reflux into the prostate; [21][22][23] (v) inappropriate cytokine release [24][25][26][27][28][29][30][31][32] and/or (vi) an autoimmune response. [33][34][35][36][37] The patients typically have repeat episodes of prostatitis and therapy is 'hit or miss'.…”

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

“…In chronic bacterial prostatitis, the spectrum of strains is wider. The significance of intracellular bacteria, such as C. trachomatis, is uncertain [257]. In patients with immune deficiency or HIV infection, prostatitis may be caused by fastidious pathogens, such as M. tuberculosis, Candida sp.…”

Association of Ureaplasma urealyticum infection with Varicocele-related infertility

“…Ureaplasma urealyticum is a self-replicating prokaryote belonging to the taxonomic class Mollicutes, which lack a cell wall. Genital U. urealyticum colonization has been found to be involved in non-gonococcal urethritis (NGU), prostatitis, epididymitis and infertility [6,7]. Some investigators reported that the presence of U. urealyticum in semen was related to a decrease in sperm density, motility and morphology [8,9,10,11].…”